15 complex claims specialist jobs found

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees...

If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Territory:   We are seeking an experienced claims professional   located   in   central/eastern Pennsylvania   to support our assigned territory.   What You Can Expect:  This position will specialize in   farm property and/or agribusiness property field claims . The role involves handling   complex commercial agribusiness and farm claims , with average claim severity ranging from   $200K to $1M+ .   Travel Requirements...

Overview Good Things Start Here. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers. Good Things You Can Count On.   Hybrid schedule: 2 days remote / 3 in‑office Predictable hours (no nights, weekends, or holidays) Competitive pay + generous PTO Medical, dental & vision starting day one 401(k), tuition reimbursement & longevity bonuses Responsibilities Berkshire Hathaway GUARD Insurance Companies is seeking a Trucking Claims Specialist to join our P&C Claims Casualty team. This role reports to the Director of Claims and is responsible for investigating and resolving commercial auto liability and physical damage claims , with...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling....

The Stop Loss Accounting Operations Specialist provides administrative processing support within the Medical Stop Loss division of One80 Intermediaries. This role supports Accounting, Claims, Premium, and Employer Groups by processing claim reimbursement communications, obtaining premium back up when needed, issuing premium late notices, ACH processing documentation, and compliance tracking. This role is critical to ensuring accurate financial transactions, regulatory compliance, and professional communication with brokers and clients. Your Impact: Prepare and distribute Explanation of Reimbursements (EORs) to brokers, TPAs, and employer groups. Coordinate claim reimbursement processing, including obtaining ACH authorization forms and managing special handling requests. Maintain accurate contact records for EOR distribution and premium billing within ESL systems. Support accounting operations by coordinating commission ACH forms and maintaining required producer W9...

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):   Medical Only Claims Adjuster   Employment Type:   Full-Time   FLSA Status:   Non-Exempt   Location:   In-Office     Summary:     We are looking for a highly capable Medical Only Claims   Adjuster to   join our Claims team and work from either our Rockwood, PA , Richmond, VA,   or Omaha, NE offices .    Alternatively, we can also fill this role in our Springfield, MO office.     The position reports to a manager based in Rockwood, PA. The Medical Only Claims Adjuster   is responsible for   managing medical-only claims for...

An exciting opportunity exists to join the ProAssurance family of companies! Our mission is powerful and simple: We protect others. Choosing a place to apply your talents is an important decision for anyone. You have plenty of options. Why choose ProAssurance? At ProAssurance, we sell a pledge, and that pledge is delivered by our team members. We are seeking individuals who value integrity, leadership, relationships, and enthusiasm—and want to build their career with a great company where they can be their authentic self and feel valued, recognized, and rewarded for their contributions. ProAssurance specializes in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. We are an industry-leading specialty insurer, with job opportunities in much of the contiguous United States. This position supports our medical professional liability line of business and...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

Crum & Forster Company Overview Crum & Forster (C&F) , with a proud history dating to 1822, provides specialty and standard commercial lines insurance products through our admitted and surplus lines insurance companies. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best and is proud of our superior customer service platform. Our claims and risk engineering services are recognized as among the best in the industry.   Our most valuable asset is our people: more than 2000 employees in locations throughout the United States. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the 2025 Great Place to Work ® Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.   C&F is part of Fairfax Financial Holdings, a global, billion dollar organization.  For more information about Crum & Forster,...

Join Starr, a global leader in commercial insurance with over a century of expertise. We empower our employees to innovate, make impactful decisions, and build lasting client relationships worldwide. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Grow your career with a rapidly growing company that invests in its people and their ability to drive real progress. Job Title:  Director, Quality Engineering Location:  New York, NY / Philadelphia, PA / Atlanta, GA Department:  Starr Technology Group Overview: The Director, Quality Engineering plays a critical leadership role responsible for operationalizing and scaling Starr’s Quality Engineering (QE) strategy. This leadership position is tasked with leading the execution of QE methodologies, managing QE teams, and driving the maturity of automated and manual...

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. While we prefer candidates who reside in Pennsylvania, we will consider those who live in any of our listed payroll approved states. We may hire a senior level and the posted salary range is inclusive of both levels. Nurse licensures in multi-states is a plus. The actual salary range for candidates who reside in Pennsylvania is $59,630 to $119,670 annually + bonus + benefits. Pay Type: Salary The position reports to the Director, Workers' Compensation Claims. Are you a Referral? If you know a current Encova...

The Broker Dealer Operations Specialist plays a central role in delivering world‑class customer and transaction servicing for alternative investment products. The role supports end‑to‑end operations from onboarding through transactions, reconciliation, and servicing requests. You are A consummate professional with excellent verbal and written communication skills Self-motivated and goal-oriented Patient, empathetic, diligent, and able to work independently in a team environment You will Serve as the SME and primary contact for Alternative Investments operational inquiries and daily processing. Develop an in‑depth understanding of iCapital platform interfaces and order entry within NetX360 to enable seamless fund launches, recurring client activities, and overall book health. Execute operations deliverables on recurring platforms; manage daily workflows and queues to meet service levels with a client‑first approach. Assist in systems testing and...